Appropriateness of Parenteral Nutrition Usage in Cancer Patients

Feng, Yulin; Lee, Chunsung; Chiu, Chong‐Chi; Chao, Chien‐Ming; Lai, Chih‐Cheng

doi:10.1080/01635581.2015.1053501

Cited by 4 publications

(1 citation statement)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A majority of the cancer patients exhibited different degrees of malnutrition and immune dysfunction before surgery, which might be attributed to the stress response to surgery and increased metabolism. Malnutrition also leads to immune suppression, accompanied by extreme weight loss [1]. In addition to other maladies, resulting in patients with postoperative infection, gastroparesis and other related complications, which seriously affect the patient’s physical recovery and quality of life [2, 3].…”

Section: Introductionmentioning

confidence: 99%

Impact of total parenteral nutrition standardization led by pharmacist on quality in postoperative patients with colorectal cancer

et al. 2018

View full text Add to dashboard Cite

Background/objectivesAbdominal surgery significantly affects the structure and function of the gastrointestinal system of patients, total parenteral nutrition (TPN) is an important nutrition support method for postoperative patients. However, in the process of TPN practice, the excessive fat emulsion and compound amino-acid prescriptions ratio are often prescribed by doctors. To address the problem, we developed the computerized TPN prescription management system to promote the personalized provision of TPN. The purpose of this study is to evaluate the intervention effects of the computerized TPN prescription management system, which is designed by pharmacists in the Surgical Department of Abdominal Oncology at Zhejiang Cancer Hospital in July 2015.Subjects/methodsThe computerized TPN prescription management system applied in Surgical Department of Abdominal Oncology on 1 July 2015. The computerized TPN prescription management system was evaluated by comparing the patients who were treated 3 months after the application of the system with the control subjects who were treated 3 months prior to the application of TPN prescription management system in Surgical Department of Abdominal Oncology.ResultsIn total, 218 TPN prescription-treated patients with colorectal cancer received surgery treatment were analyzed, including 121 subjects who received the treatment 3 months prior to application of TPN prescription system (IPN period) and 97 subjects who received the treatment after 3 months of the system application (SPN period). The rates of optimized TPN prescriptions are 47.1% and 88.7% prior to and after application of TPN prescription review system, respectively (p < 0.001). In detail, prior to application of TPN prescription review system, abnormal glucose–lipid ratio and nitrogen–calorie ratio are the most common problems, which accounted for 74.3 and 97.9%, respectively (p < 0.01). Whereas the proportion of the insufficient dosage of amino acids is 62 and 96.9%, respectively (p < 0.01). Other problems are insufficient dosage of insulin and excessive fat soluble vitamin supplement. After application of TPN prescription review system, as the glucose–lipid ratio and nitrogen–calorie ratio are set up in fixed range according to the nutrition treatment guidelines, only a small amount of TPN prescriptions have the problem of insufficient dosage of compound amino acid. Furthermore, before and after the application of TPN management software, the gender, age, performance status (PS) score and BMI index of the two groups of colorectal cancer patients were not statistically different (p > 0.05). There were significant differences in albumin and prealbumin between the two groups after operation (p < 0.05), and there was a significant difference in total protein (p < 0.001). There were significant differences in alanine aminotransferase and indirect bilirubin between liver and kidney function (p < 0.01), and there were significant differences in aspartate aminotransferase and total bilirubin (p < 0.05). Other total cholestero...

show abstract

Section: Introductionmentioning

confidence: 99%

Impact of total parenteral nutrition standardization led by pharmacist on quality in postoperative patients with colorectal cancer

et al. 2018

View full text Add to dashboard Cite

show abstract

Lipid peroxidation: Its effects on the formulation and use of pharmaceutical emulsions

Khanum

Thevanayagam

2017

Asian Journal of Pharmaceutical Sciences

View full text Add to dashboard Cite

Overuse of Health Care Services in the Management of Cancer

et al. 2017

View full text Add to dashboard Cite

Background Overuse, the provision of health services for which harms outweigh the benefits, results in suboptimal patient care and may contribute to the rising costs of cancer care. We performed a systematic review of the evidence on overuse in oncology. Methods We searched Medline, EMBASE, the Cochrane Library, Web of Science, SCOPUS databases, and two grey literature sources, for articles published between December 1, 2011 and March 10, 2017. We included publications from December 2011 to evaluate the literature since the inception of the ABIM Foundation’s Choosing Wisely initiative in 2012. We included original research articles quantifying overuse of any medical service in patients with a cancer diagnosis when utilizing an acceptable standard to define care appropriateness, excluding studies of cancer screening. One of 4 investigator reviewed titles and abstracts and 2 of 4 reviewed each full-text article and extracted data. Methodology used PRISMA Guidelines. Results We identified 59 articles measuring overuse of 154 services related to imaging, procedures, and therapeutics in cancer management. The majority of studies addressed adult or geriatric patients (98%) and focused on US populations (76%); the most studied services were diagnostic imaging in low-risk prostate and breast cancer. Few studies evaluated active cancer therapeutics or interventions aimed at reducing overuse. Rates of overuse varied widely among services and among studies of the same service. Conclusion Despite recent attention to overuse in cancer, evidence identifying areas of overuse remains limited. Broader investigation, including assessment of active cancer treatment, is critical for identifying improvement targets to optimize value in cancer care.

show abstract

Appropriateness of Parenteral Nutrition Usage in Cancer Patients

Cited by 4 publications

References 15 publications

Impact of total parenteral nutrition standardization led by pharmacist on quality in postoperative patients with colorectal cancer

Impact of total parenteral nutrition standardization led by pharmacist on quality in postoperative patients with colorectal cancer

Lipid peroxidation: Its effects on the formulation and use of pharmaceutical emulsions

Overuse of Health Care Services in the Management of Cancer

Contact Info

Product

Resources

About